Teamsters Local 170 Health and Welfare Fund

Summary Plan Description (SPD)

The Teamsters Local 170 Health and Welfare Plan offers you and your family a large measure of financial security. The Plan offers you a choice of plan options. Choose the one to enroll in that best serves the needs of you and your family.

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Early Retiree Plan

Our Early Retiree Plan offers a comprehensive benefits plan with a choice of Blue Cross Blue Shield of MA or Fallon Community Health Plan. This section of our site describes the benefits, the eligibility rules and the procedure you should follow in order to obtain benefits through the Plan.

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Member Portal

Our online member portal is the perfect way to keep in touch with us! Members can log in and check for plan updates and other Fund information.

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Bulletin Board


Women’s Health and Cancer Rights Act (WHCRA) Notice
The Women’s Health and Cancer Rights Act of 1998 requires group health plans to make certain benefits available to participants. Please see the notice for detailed information.
Women’s Health and Cancer Rights Act (WHCRA) Notice (PDF Document Format)

ER Alternatives – Announcements for 2017
Please see the latest information on our 2017 ER alternatives.
ER Alternatives – Blue Cross Blue Shield (PDF Document Format)
ER Alternatives – Fallon (PDF Document Format)

Wellness Program for 2017
Please see the latest information on our 2017 Wellness Program.
Wellness Program 2017 (PDF Document Format)

Notices of Non-Discrimination (October 14, 2016)
BCBS Notice of Non Discrimination (PDF Document Format)
Fallon Notice of Non Discrimination (PDF Document Format)

Nondiscrimination and Accessibility Requirements and Nondiscrimination Grievance Procedure (PDF Document Format)
Affordable Care Act Grievance Procedure (PDF Document Format)

HIPAA Notice of Privacy Practice (April, 2016)
This notice describes how medical information about you may be used and disclosed and how you get access to this information.
HIPAA Notice of Privacy Practice (PDF Document Format)

Benefit Enhancement Information (October, 2015)
This notice is to inform you of coverage enhancements and/or changes for the benefits to Active and Retiree members through Blue Cross Blue Shield of Massachusetts and Fallon Health plans.
Benefit Enhancement Information (PDF Document Format)

SUMMARY ANNUAL REPORT
The Summary Annual Report is available now for the period January 1, 2014 to December 31, 2014.
Summary Annual Report – 2014 (PDF Document Format)

PRESCRIPTION DRUG AND MEDICARE NOTICE
Information about current prescription drug coverage and options under Medicare’s prescription drug coverage.
Prescription Drug Notice – 2015 (PDF Document Format)

CHILDREN’S HEALTH INSURANCE PROGRAM
Please review the latest inform for CHIP Premium Assistance programs. This notice is effective September 2015.
CHIP Notice – 2015 (PDF Document Format)

Summary of Material Modifications

Summary of Material Modifications – Health and Welfare Fund (June 21, 2017)
Changes in the benefits offered to Active and Retiree members through Blue Cross BlueShield of Massachusetts (BCBSMA)
Coverage Changes Notice (PDF Document Format)

Summary of Material Modifications – Health and Welfare Fund (October 31, 2016)
Changes to Plan benefits notice.
Coverage Changes Notice (PDF Document Format)

Summary of Material Modifications – Health and Welfare Fund (April 8, 2016)
Changes to Plan benefits notice.
Coverage Changes Notice (PDF Document Format)

Summary of Material Modifications – Health and Welfare Fund (September 30, 2015)
Coverage enhancements effective January 1, 2016 for the fitness benefits offered to all Active and Retiree members through the BCBSMA and Fallon health plans, the dental benefits offered to all Active members through Blue Cross Blue Shield of Massachusetts (BCBSMA) and the vision benefits offered to all Active and Retiree members through Davis Vision.
Benefit Enhancement Information (PDF Document Format)

Summary of Material Modifications – Health and Welfare Fund (April 30, 2015)
Changes to coverage through BCBSMA medical and pharmacy benefit that become effective July 1, 2015.
Coverage Changes to BCBSMA Medical and Pharmacy Benefit (PDF Document Format)
BCBS Pharmacy Benefit Handbook (April 23, 2015) (PDF Document Format)

Summary of Material Modifications – Health and Welfare Fund (April 8, 2016)
Changes to Plan of benefits notice.
Coverage Changes Notice (PDF Document Format)

Summary of Material Modifications – Health and Welfare Fund (September 30, 2015)
Coverage enhancements effective January 1, 2016 for the fitness benefits offered to all Active and Retiree members through the BCBSMA and Fallon health plans, the dental benefits offered to all Active members through Blue Cross Blue Shield of Massachusetts (BCBSMA) and the vision benefits offered to all Active and Retiree members through Davis Vision.
Benefit Enhancement Information (PDF Document Format)

Summary of Material Modifications – Health and Welfare Fund (April 30, 2015)
Changes to coverage through BCBSMA medical and pharmacy benefit that become effective July 1, 2015.
Coverage Changes to BCBSMA Medical and Pharmacy Benefit (PDF Document Format)
BCBS Pharmacy Benefit Handbook (April 23, 2015) (PDF Document Format)

Summary of Material Modifications – Health and Welfare Fund (October 30, 2014)
Changes made to the Plan of Benefits of the Teamsters Local 170 Health and Welfare Fund that become effective January 1, 2015.
Summary of Material Modifications (PDF Document Format)
BCBS Pharmacy Benefit Handbook (January 1, 2015) (PDF Document Format)

Summary of Material Modifications – Health and Welfare Fund (October 18, 2013)
Changes made to the Plan of Benefits of the Teamsters Local 170 Health and Welfare Fund that become effective January 1, 2014.
Summary of Material Modifications (PDF Document Format)

Summary of Benefits and Coverage

Newsletters

June 2017 (PDF Document Format)

Davis Newsletter 2017 (PDF Document Format)

January 2017 (PDF Document Format)

October 2016 (PDF Document Format)

April 2016 (PDF Document Format)